A3/A4 question type
1. Female, 45 years old. 5 years of recurrent episodes of epigastric pain, accompanied by increased urinary amylase, and repeatedly diagnosed as acute pancreatitis. In the last 2 months, the abdominal pain was persistent, aggravated after meals, with greasiness and undigested food residue in the stool. There is significant weight loss since the onset of the disease
1 point for this question
(1). The laboratory test that should be preferred for a definitive diagnosis is
A. Blood amylase
B. Cam/Ccr%
C. Blood lipase
D. Liver function
E. BT-PABA
Answer No. 41323
Correct Answer C
Answer Explanation Blood lipase Blood lipase activity is increased in acute pancreatitis. It begins to rise 4 to 8 hours after onset of the disease and lasts for l0 to 15 days, and is more specific than amylase because of its low tissue origin.
(2). The most likely diagnosis is
A. Recurrence of acute pancreatitis
B. Chronic cholecystitis
C. Chronic pancreatitis
D. Cancer of the pancreas
E. Chronic hepatitis
Answer No. 41324
Correct Answer A
(3). Pharmacologic therapy for this patient should be considered as a choice of
A. Pancreatic enzymes
B. Gastric mucosal protectants
C. Inhibition of gastric acid secretion
D. Broad-spectrum antibiotics
E. Hepatoprotective cholagogues
QUESTION NO. 41325
CORRECT ANSWER C
Answer Explanation The most The most critical treatment for acute pancreatitis is inhibition of pancreatic secretion, so fasting and gastrointestinal decompression are necessary to prevent the prosecretory effect of gastric acid on pancreatic juice.
2. Female, 30 years old, 1 month low-grade fever, night sweats, fatigue, poor appetite, lethargy, increased frequency of bowel movements, 3 times a day, paste-like, accompanied by vague pain in the lower abdomen. Physical examination: right lower abdomen can be found mass, clear boundary, medium hard texture, poor mobility, turbid tone on percussion, pressure pain, positive PPD test. Blood WBC was normal, Hb1O0g/L, blood sedimentation 58mm/h, stool routine WBC 8-10/HP, RBC 4-6/HP
1 point for this question
(1). The diagnosis of this patient is first considered
A. Crohn's disease
B. Ulcerative colitis
C. Intestinal tuberculosis
D. Abdominal lymphatic tuberculosis
E. Colorectal cancer
Answer No. 41327
Correct Answer C
(2). To make a definitive diagnosis, the preferred adjunctive examination is
A. colonoscopy
B. abdominal plain film
C. total gastrointestinal imaging
D. stool culture
E. laparoscopy
Answer No. 41328
Correct Answer A
(3). Which of the following examinations should be avoided when the patient has a manifestation of intestinal obstruction
A. Abdominal ultrasound
B. Total gastrointestinal angiography
C. Anal fingerprinting
D. Abdominal plain radiographs
E. Abdominal CT examination
QUESTION NO. 41329
CORRECT ANSWER B
ANSWER RESOLUTION The patient herself The patient has a bowel obstruction, and drinking barium will aggravate the obstruction.
3. A 65-year-old man with a 2-month history of cough and hemoptysis presents with a 10-year history of chronic bronchitis and denies any other medical history. He has smoked for 40 years, 1 pack per day. x-ray chest radiograph showed central lung cancer in the right lower lung
1 point for this question
(1). The first test that should be considered for a definitive pathological diagnosis is
A. sputum search for tumor cells
B. ultrasound-guided percutaneous lung puncture
C. CT-guided percutaneous lung puncture
D. transfibreoptic bronchoscopic biopsy
E. blood test for tumor markers of lung cancer
Answer No. 41331
Correct Answer D
Answer Explanation
(2). The findings are squamous carcinoma with no signs of metastasis, and the patient wishes to undergo surgical resection of the right lower lobe. which of the following tests suggests that the patient is not amenable to surgical intervention
A. Residual air volume/total lung volume is 45%
B. FEV1 is 780 ml
C. FEV1/FVC is 70%
D. CO dispersion is 69% of the expected value
E. PaCO2 43 mmHg
Answer No. 41332
Correct Answer B
(3). In the course of hospitalization, the patient suddenly developed fever and dyspnea, X-ray chest radiograph showed obstructive pneumonia in the right lower lung, blood gas examination showed pH 7.42, PaCO2 54mmHg, PaO2 55mmHg, that is, the patient was given oxygen by mask, and half an hour later the patient lost consciousness. Physical examination: BP120/80mmHg, both pupils are equal in size and round, light reflex is slightly retarded. In order to clarify the diagnosis, the first examination should be
A. electroencephalogram
B. blood gas analysis
C. cranial CT
D. blood biochemistry+electrolytes
E. blood culture+pharmacological sensitization
Answer No. 41333
Correct Answer B
4. The patient is a male, 40 years old, with a history of hypertension for 10 years. Previous history of hypertension for 10 years with poor blood pressure control. In the morning, severe tearing chest pain suddenly appeared, and the pulse of one side of the upper extremity disappeared. Heart rate was 110 beats/minute, rhythmic, diastolic murmur in the aortic valve area, and the electrocardiogram was generally normal
1 point for this question
(1). The initial diagnosis is
A. aortic dissection
B. acute myocardial infarction
C. hypertensive encephalopathy
D. aortic valve closure insufficiency
E. pulmonary embolism
Answer No. 41335
Correct Answer A
Answer Explanation He had previously had poorly controlled blood pressure and had sudden severe tearing chest pain, loss of pulse in one upper extremity, and diastolic murmur in the aortic valve area are considered.
(2). Which of the following is considered to be the most common cause of this disease
A. Left atrial mucinous tumor
B. Hypertension
C. Endovascular endocarditis
D. Vascular malformation
E. Aortic constriction
Answer No. 41336
Correct Answer B
Answer Resolution Hypertension is an important factor leading to entrapment. The answer is that hypertension is an important factor in the development of a coarctation.
(3). The patient's blood pressure is elevated to 185/125 mm Hg. Which of the following medications would be most appropriate
A. Cardioplegia
B. Sodium nitroprusside
C.? Receptor blockers
D. Nitroglycerin
E. Captopril
Answer No. 41337
Correct Answer B
Answer Explanation Sodium nitroprusside rapidly lowers blood pressure.
(4). Which of the following should be considered first in the case of sudden hypotension
A. Pulmonary infarction
B. Cardiac tamponade
C. Acute myocardial infarction
D. Inadequate intake
E. Arrhythmia
Answer #41338
Correct Answer B
Answer Explanation A rupture of the lamina propria into the pericardial cavity can cause cardiac tamponade, which can be caused by the rupture of the laminations into the pericardial cavity, which can cause cardiac tamponade. cavity can cause cardiac tamponade, resulting in hypotension.
5. Male, 49 years old. Fever, cough for nearly 2 weeks, sputum little, color even yellow, accompanied by chest tightness. 2 days since the hemoptysis to see the doctor, most of the mouth full of fresh blood, about 50 ml per day. physical examination: the right upper lung percussion turbidity, breath sound low, heard wet rales. Chest X-ray showed solid changes in the upper lobe of the right lung with cavity formation, the diameter of the cavity was about 2.5 cm, the wall of the cavity was smooth, and there was no fluid level.
1 point for this question
(1). The initial diagnosis of this case is first considered
A. Fungal pneumonia with abscess formation
B. Lung abscess
C. Lung cancer with carcinomatous cavity
D. Lung cyst with secondary infection
E. Tuberculosis
Answer No. 41353
Correct Answer E
(2). The easiest and most useful test specimen for the diagnosis of this case is
A. sputum
B. anti-pollution sample, brush sampling specimen
C. transbronchial suction specimen
D. bronchoalveolar lavage
E. transbronchial lung biopsy specimen
Answer No. 41354
Correct Answer A
(3). If the above tests still fail to confirm the diagnosis, which of the following tests would be most helpful in making a definitive diagnosis
A. CT
B. Percutaneous lung aspiration biopsy
C. Fiberoptic bronchoscopy
D. MRI
E. Color ultrasonography
QUESTION NO. 41355
Correct Answer C
(4). [Hypothetical information] If there is still no conclusive evidence of a diagnosis, but the tendency is toward tuberculosis, and lung cancer cannot be ruled out. Clinical management should be
A. No special treatment, close medical observation
B. Experimental antituberculosis treatment for no shorter than 3 months
C. Experimental antituberculosis treatment for 1 month with follow-up chest radiographs and related tests
D. Surgery
E. Antituberculosis chemotherapy combined with low-dose anticancer chemotherapy
Answer No. 41356
Correct Answer C
(5). The patient's hemoptysis worsened and the volume of hemoptysis exceeded 600 ml in 24 h. The focus and principle of management of hemoptysis is
A. Immediately give posterior pituitary hormone to stop hemoptysis
B. Maintaining airway patency and preventing alveolar fillings
C. Guaranteeing the effective blood volume and active blood transfusion
D. Preventing the spread of pulmonary tuberculosis
E. Intensifying chemotherapy and Control the underlying disease as soon as possible
Answer No. 41357
Correct Answer B
Answer Explanation The greatest danger of hemoptysis is asphyxia or filling of the alveoli with blood clots, which causes acute hypoxia, and so treatment focuses on preventing and dealing with this complication. Hemostasis is obviously important, but there is no specific hemostatic drug. Ensuring effective blood volume is also important, but hemoptysis is less likely to cause circulatory failure.
(6). [Hypothetical message] If a patient is finally diagnosed with tuberculosis and given a regular short course of antituberculosis chemotherapy for 9 months, the lesion is significantly resorbed, the cavity shrinks, and the walls of the cavity thin but fail to close. His further management should be
A. Addition of an artificial pneumoperitoneum to induce closure of the cavity
B. Continuation of chemotherapy and follow-up until closure
C. Surgery
D. Switching to a more effective chemotherapeutic regimen
E. Review of sputum bacteria, which is not necessary as long as sputum bacteria continue to be negative
Answer No. 41358
Correct Answer E
6. Male, 25 years old, came to the clinic 3 days ago with a sudden onset of high fever and chills after exposure to the cold, in the form of an episodic fever, accompanied by herpes at the corners of the mouth. Physical examination: right upper lung was substantial on percussion, and pathologic bronchial breath sounds were detected. Laboratory tests: white blood cell count 20.1?109/L, classification: neutrophils 0.90, left shifted karyotype and toxic granules.
1 point for this question
(1). Regarding the diagnosis of this case, the basic examination that is still needed should be
A. X-ray chest radiograph
B. CT
C. MRI
D. Bronchial stratification radiograph
E. High-kilovolt chest radiograph
Answer No. 41366
Correct Answer A
(2). The etiologic diagnosis regarding this case is most likely to be
A. Staphylococcus aureus
B. Streptococcus pneumoniae
C. Pseudomonas aeruginosa
D. Klebsiella pneumoniae
E. Legionella pneumophila
Answer No. 41367
Correct Answer B
(3). Given that bacterial resistance tends to be a prominent problem, empiric antimicrobial therapy in this case would be appropriate
A. Penicillin
B. First- or second-generation cephalosporin
C. Amikacin
D. Ciprofloxacin
E. Ceftazidime
QUESTION NO. 41368
CORRECT ANSWER B
7. Male, 34 years old. Acute respiratory distress syndrome (ARDS) complicated by multiple fractures due to a fall from a height; the fractures have been managed and he is being treated with an artificial airway and positive end-expiratory pressure mechanical ventilation
1 point for this question
(1). In order to prevent pulmonary infections, which of the following measures is the most important in targeting exogenous routes of infection
A. Strict aseptic practices, sterilization of instruments
B. Isolation
C. Air disinfection
D. Disinfection of floors and walls
E. Suctioning
Answer No. 41394
Correct Answer A
(2). The most important source of endogenous hospital-acquired lung infection-causing organisms is
A. Gastrointestinal and oropharyngeal colonizers
B. Skin colonizers
C. Biliary colonizers
D. Perineal colonizers
E. Skin fungi, such as tinea corporis
Answer No. 41395
Correct Answer A
(3). To prevent endogenous lower respiratory tract infections, the main measures that should be taken are
A. Prophylactic application of broad-spectrum antibiotics
B. Switching from tracheal intubation to tracheotomy
C. Avoiding the application of H2-receptor blockers to prevent the elevation of gastric fluid pH, and a trial of selective gastrointestinal decontamination
D. Preventing vomiting
E. Increasing the patient's immunity, such as injection of immunoglobulin
Answer No. 41396
Correct Answer C
Answer Explanation The gastrointestinal tract is the main source of endogenous infectious bacteria, and retrograde movement of bacteria in the lumen of the stomach is an important pathway for colonization of oropharyngeal pathogens. During prolonged mechanical ventilation, doctors often use antacids and H2 receptor blockers to prevent or treat stress gastric ulcers, causing the pH of the patient's gastric juice to rise, leading to the overgrowth of gram-negative bacilli in the stomach; in patients on prolonged mechanical ventilation, the placement of gastric tubes due to gastrointestinal nutritional needs will weaken the esophageal sphincter function, which is prone to gastroesophageal reflux; and sedatives can inhibit the patient's swallowing reflex and cough reflex. Sedatives can suppress the patient's gag reflex and cough reflex. The above situations can make gastric contents and oropharyngeal secretions inhaled into the lower respiratory tract, resulting in easy displacement of bacteria, the formation of ? Gastrointestinal? Oral? Lower respiratory tract? Such a channel, causing the occurrence of VAP.
B1 Question Type
1. A. Escherichia coli
B. Haemophilus influenzae
C. Pseudomonas aeruginosa
D. Mycobacterium tuberculosis
E. Anaerobic bacteria
1 point for this question
(1). Bacteria that stain positively for antacids are
Answer ID 41341
Correct Answer D
(2). The bacteria for which the new macrolide antibiotics are effective in treatment are
QUESTION NO. 41342
CORRECT ANSWER B
2.
A. Production of endotoxin
B. Production of exotoxin
C. Production of hemolysin
D. Production of plasma coagulase
E. Tissue invasion by podocarps Role
1 point for this question
(1). The primary pathogenic mechanism of gram-negative bacilli is
Answer No. 41360
Correct Answer A
(2). The main pathogenic mechanism of Streptococcus pneumoniae is
QUESTION NO. 41361
CORRECT ANSWER E
(3) A. Pneumococcal pneumonia
B. Staphylococcus aureus pneumonia
C. Klebsiella pneumonia
D. Mycoplasma pneumonia
E. Viral pneumonia
This question1 Score
(1). Antibiotic therapy is ineffective
Answer #41363
Correct Answer E
(2). Pathogenicity is related to the coagulase produced by the bacteria
QUESTION NO. 41364
CORRECT ANSWER B
X QUESTION TYPE
1. Which of the following is true about duodenal ulcers
A. Increased total number of mural cells
B. Low prevalence of Helicobacter pylori infection
C. Increased gastric acid secretion
D. Increased vagal tone
E. Delayed gastric emptying
1 point for this question
Answer No. 41343
Correct Answer A, C, D
Answer Analysis The etiology and pathogenesis of those with duodenal ulcers: increased gastric acid secretion (the main factors for this are: Increased number of mural cells and increased secretion, increased sensitivity of mural cells to stimuli, defects in the normal feedback inhibitory mechanism of gastric acid secretion, and increased vagal tone); Helicobacter pylori infection; nonsteroidal anti-inflammatory drugs; gastroduodenal motility abnormality (accelerated gastric emptying); hereditary factors; environmental factors; psychiatric factors; and diseases associated with peptic ulcer.
2. Adverse effects of cyclophosphamide include
A. alopecia
B. abnormalities of liver function
C. decrease in blood leukocytes
D. increase in appetite
E. visual field defects
1 point for this question
Answer No. 41344
Correct Answer A, B, C
Answer Analysis Cyclophosphamide can cause leukopenia, gastrointestinal symptoms such as diarrhea, fear of food, nausea or vomiting; used in the treatment of leukemia or lymphoma is prone to hyperuricemia and uric acid nephropathy; large doses of the drug and a large number of rehydration can produce water toxicity; high doses of myocardial necrosis, and occasionally occur in the lung fibrosis; long term administration of the drug, secondary tumors; large doses of injections can produce Severe hemorrhagic cystitis, bladder irritation symptoms; rare fever, allergy, alopecia, urticaria, oral mucosal ulcers, oropharyngeal sensory abnormalities, blurred vision, skin and nail bed hyperpigmentation, ALT elevation, hyperkalemia, menopause or spermatozoa deficiency, teratogenicity of the drug in the early stages of pregnancy.
3. A generalized seizure belongs to epilepsy (according to the International Classification)
A. Atypical seizures
B. Automatisms
C. Clonic seizures
D. Atonic seizures
E. Jackson's epilepsy
1 point for this question
Answer No. 41345
Correct Answer A, C, D
4. Complications of gastric cancer include
A. Bleeding
B. Infection
C. Pyloric obstruction
D. Perforation
E. Bowel obstruction
This question is worth 1 point
Answer No. 41346
Correct Answer A, C, D
Answer Explanation The main complications of gastric cancer are bleeding, pyloric or cardia obstruction, and perforation.
5. Chronic bacillary dysentery is characterized by
A. a history of acute bacillary dysentery in most cases
B. it occurs more often in people with chronic illnesses
C. prolonged and recurrent diarrhea with abdominal pain
D. it may be accompanied by symptoms such as malaise and anemia
E. the disease remains unrecovered for more than a month
1 mark for this question
QUESTION NO. 41369
CORRECT ANSWER A, B, C, D
6. What is the difference in the diagnostic criteria for SLE between the 1997 and l982 ACRs
A. The 1997 ACR's diagnostic criteria for SLE do not include lupus-cell positivity
B. The 1997 ACR's diagnostic criteria for SLE include positive anti-dsDNA antibodies, positive anti-dsDNA antibodies, and positive anti-dsDNA antibodies. dsDNA antibody positivity and anti-Sm antibody positivity
C. The 1982 ACR diagnostic criteria for SLE include antiphospholipid antibody positivity (the latter includes one of anticardiolipin antibody, or lupus anticoagulant positivity, or false-positive syphilis serologic test that has lasted at least 6 months)
D. The 1982 ACR diagnostic criteria for SLE do not include lupus cell Positive
E. The 1997 ACR diagnostic criteria for SLE include positive lupus nephritis pathology
1 point for this question
Answer No. 41374
CORRECT ANSWER A, B
7. Elderly systemic lupus erythematosus is characterized by the following
A. A mostly slow onset, insidious disease
B. The combination of renal damage, Raynaud's phenomenon and psychiatric symptoms is less common, while lung and pleural damage is more frequent
C. The positivity rate of anti-ds?DNA antibody and anti-Sm antibody is higher
D. It responds well to hormones
E. The prognosis is relatively poor
1 point for this question
Answer No. 41375
Correct Answer A, E
8. The drugs that can be used to control malaria episodes are
A. Chloroquine
B. Primaquine
C. Quinine
D. Ethacridine
E. Artemisinin
1 point for this question
Answer No. 41376
Correct Answer A, C, E form Bottom